Treatment includes partial exchange transfusion or increased fluid intake for polycythemia, and iron supplementation with measures to limit blood loss for anemia in LBW neonates.
Polycythemia
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Symptomatic infants and asymptomatic infants with hematocrit >75% require partial exchange transfusion.
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Partial exchange transfusion involves removing 25–50 mL/kg of blood and replacing it with normal saline.
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For other infants with polycythemia, management includes increasing fluid intake.
Anemia
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All LBW neonates should receive iron supplementation at a dose of 2–3 mg/kg from 2 months until 2 years of age.
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Blood sampling should be minimized.
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Transfusions are given according to the institution's protocol.